03/09/2010 Semester I

SUBMITTED BY DIPTI SUGANDH AND NARINDER KAUR (M.TECH FBT)

Food Borne Diseases

It is the illness caused due to ingestion of food contaminated with pathogens.
There are two types of food borne diseases:

FOOD INTOXICATION
Chemical or natural toxin

FOOD INFECTION
Micro organism itself grow inside

produced by micro organism (also called as exotoxin)causes disease Incubation period is shorter Most prevelant symptoms: nausea and vomiting Staphylococcus aureus, Clostridium perfringens, and Clostridium botulinum

the body and causes disease Incubation period is longer Most prevelant symptoms: diarrhea, stomach cramps, fever and chills Salmonella, Enteropathogenic E.coli, Listeria monocytogenes, Shigella, Vibrio parahaemolyticus, Norwalk Viruses, and Hepatitis A

--Reference from Modern Microbiology by Jay 7th edition, Springer 2005

FOOD BORNE INFECTION

Illness caused when the pathogenic organism is

ingested and it grow in body thus causing damage. They are caused by viable, multiplying microorganisms that invade the Gastrointestinal Tract.

Submitted by DIPTI SUGANDH

ORGANISM

CHARACTERISTIC

SOURCE OF CONTAMINATION

DISEASE

Salmonella

Present in fecal matter in human and animals Gram negative bacteria Facultative anaerobe Optimum growth conditions: pH 4 and 37 degree Celsius.

Escherichia coli

Drinking water and food contaminated with feces. Also, Poultry, eggs, unpasteurized milk. Vegetables grown in fields exposed to Generally Present in Gut Flora sewage, polluted contaminated but enteropathogenic strains irrigation water enter through food Facultative anaerobe Gram Negative rods Produce endotoxins Optimal temperature for growth- 37 degree celsius and pH 4.5-8
Gram negative rod Facultative anaerobe Produce enterotoxins (shiga toxin), a neurotoxin Cannot penetrate the intestinal wall

Enteric fever, gastroenteritis, septicemia

Travelers diarrhea, acute gastroenteritis in children

Shigella

Shigellosis (bacillary dysentery) Diarrhea containing blood, pus, mucus

SALMONELLA
Genus: Enterobacteriaceae Species: Salmonella Have 2500 serotypes

Grouped based on on antigenic patters of Somatic antigen (O), Flagellar antigen (H) and Capsular antigen (Vi). Two subspecies : S.enterica and S.bongori Infections caused by salmonella are Enteric Fever ( typhoid and paratyphoid fever) Gastroentritis Septicemia Can be destroyed by ionizing radiation, pasteurization and freezing

Reference - Food Borne Microbial Pathogens by Arun.K.Bhunia, Food science text series, Springer 2008

Invasion of Salmonella in the Host

List of few serovars with their pathway of invasion

SEROVAR NAME S.paratyphi HUMAN DISEASE Enteric (paratyphoid) fever or Gastroentritis Gastroentritis, septicemia, or focal infection Enteric fever or Gastroentritis Enteric (typhoid) fever PATHWAY OF INVASION M cells and dendritic cells M cells, dendritic cells

S.Typhimurium

S.Cholerasius

M cells , dendritic cells and membrane ruffling M cells and dendritic cells

S.Typhi

S.enteritidis

Gastroentritis

Membrane ruffling

ENTERIC FEVER Incubation time 1 week to 1 month Symptoms appear in 1-2 weeks: Continued fever, anorexia, chills,convulsions, Delerium, enlargement of spleen, intestinal ulcers.

GASTROENTRITIS Incubation time 12-24hrs Symptoms appear in 6-24 hrs: Fever, bloody or non bloody diarrhoea, abdominal pain and sometimes vomiting Symptoms persist for 2-3 days

SEPTICEMIA

Symptoms: High fever, chills, rapid breathing and heart rate, red spots on body (petechiae) .

Diagnosis: ELISA, Dot blot immunoassay , Nucleic acid based assays such as RT-PCR can be used for detection. Widal test for is specifically used for detection of typhi and paratyphi. Treatment: Flouroquinolone is most effective. Prevention: Live attenutated Oral Vaccine available Even after treatment can lead to secondary infection. Treatment : It is self limiting hence no antibiotics are given. But to prevent systemic infection chloramphenicol can be given. Treatment: Ampicillin or chloramphenicol

Disease lasts for 2-5 days without medication

Recurrent infection can lead to damage of

OUTBREAK

Recent outbreak of Salmonella enteritidis From May 1- August 25, 2010 was reported in eggs in the U.S by the Centre of Disease Control and Prevention.

Ref : http://www.cdc.gov/salmonella/enteritidis/

Precautions
A few simple precautions can reduce the risk of food borne diseases:

Hands should be washed before preparing food and people suffering from diarrheal illness should avoid food preparation as this can spread salmonella, shigella , Ecoli. CLEAN: Fresh fruits and vegetables should be rinsed in running tap water to remove visible dirt and grime, Also the outermost leaves of a head of lettuce or cabbage should be discarded. This is because bacteria can grow well on the cut surface of fruit or vegetable. Care should be taken to not contaminate these foods while slicing and the cut produce should be avoided to be left at room temperature for many hours. SEPARATE: Avoid cross-contaminating foods by washing hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch another food. Cooked meat should be put on a clean platter, rather back on one that held the raw meat. COOK :meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160o F. Eggs should be cooked until the yolk is firm. CHILL: Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours. Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration. REPORT: Suspected food borne illnesses should be reported immediately to the local healh department. The local public health department is an important part of the food safety system.

References:
Academic Press,Text book of Food Borne diseases by

Dean.O.Oliver, 1990 Food science text series, Modern Food Microbiology by James.N.Jay, 7th edition Springer 2005 Food Science text series, Food Borne Microbial Pathogens by Arun.k.Bhuniya, Springer, 2008 Tata McGraw Hill Publishing company Limited, Textbook of Microbiology by M.Pelczar, 5th edition, 2005

FOOD BORNE INTOXICATION

Refers to ingestion of toxins contained within the food

including bacterially produced exotoxins, which can happen even when the microbe which produced the toxin is no longer present or is not able to cause the infection
Bacterial intoxication: exotoxins produced by bacteria are

responsible for causing illness

Non bacterial intoxication: presence of harmful chemicals like

fertilizers, pesticides etc. causes illness

Submitted By Narindar Kaur

CAUSES OF FOOD INTOXICATION

Presence of bacterium in the water.
The staples for the food might arrest toxins. Food coaches may have a few infective diseases. Some animals like dogs, rats might pollute the food. Advisedly human blending toxins in the food. e.g. In spices etc.

MECHANISM OF ACTION
Intake of contaminated food Incubation period delay between intake of contaminated food and appearance of

first symptom of illness Ranges from hours to days depending upon type and quantity of food intake Incubation period of 1-6 hrs shows infection by a bacterial toxin or chemical rather than by live bacteria During the incubation period, microbes pass through the stomach into the intestine, attach to the cells lining the intestinal walls, and begin to multiply there. Some types of microbes stay in the intestine, some produce a toxin that is absorbed into the bloodstream, and some can directly invade the deeper body tissues. The symptoms produced depend on the type of microbe

MICRO ORGANISMS & THEIR SOURCE,SYMPTOMS & PREVENTION OF FOOD INTOXICATION

Micro organism Char acteri stics Heat stable source Food containing micro organism Prefer pH above 4.5, so found in acid juices like tomatoes, citrus juices, pickles etc, symptoms prevention

Staphylococ cus aureus

Domestic animals; cuts, scratches, boils, pimples of the skin

headache, nausea, vomiting, stomach cramps, diarrhea

1. As it grows well in rang e 40140F, so food should be cooled below or heated above this range 2. Keep cuts, sores covered and avoid hand contact with cooked food

Micro organism

Characteris tics

source

Food containing micro organism

Grow above pH 4.6, so meats and most vegetables contain it

symptoms

prevention

Clostridium botulinm

Anaerobe, heat resistant spore, produces toxins b/w 38F-118F

Soil, water, sewage, intestine s of human and animals

fatigue, dizziness, headache, vomiting, diarrhea, nausea, acute indigestion followed by constipation, vision, difficulty swallowing or speaking. Throat constriction and muscle paralysis come in the final stages, followed by death due to suffocation,

use an approved processing time and temperature when home canning food.

Staphylococcus aureus
Introduction:
Widespread and relatively frequent; one of the principal acute

food intoxications in North America. About 30% of the people are believed to be the carrier of this pathogen bacterial growth may not cause any off color, odor, or textural or flavor change, but the toxin is secreted into the food.
Incubation period: 30 min-8 hrs usually 4-8 hrs

 Transmission: Able to grow in wide range of temperature, pH 4.2-9.3 &

sodium chloride concentrations, so is contained in wide range of food varieties Often this type of food poisoning occurs when cooked food is allowed to cool slowly and/or sit at room temperature for some time. Food at higger risk are those that are prepared by hand and require no cooking like pasteries, pudding, sliced meat etc. Transmitted by cuts, wound on skin. Human and animals are the primary reservoirs
Susceptibility:

Most of the people are susceptible to staphylococcus toxins

 Diagnosis: Recovery of large no of S.aureus (105 organisms/g of food) on

routine culture media or detection of enterotoxin from epidemiologically implicated food item confirms the diagnosis heat killed staphylococci in the food can be confirmed by gram stain of the heated food Isolation of organisms of the same type by pulsed field gel electrophoresis from stools of two or more ill persons also confirms the diagnosis
Control:
Supportive therapy and fluid replacement may be provided

when required

 Educate food handlers in strict food hygiene, including

cleanliness of kitchens, proper temperature control, hand washing, cleaning of fingernails and the danger of working with the exposed skin, nose and eye infections and the need to cover wounds. reduce food handling time to an absolute minimum, with not more than 4 hrs at ambient temperature Keep perishable foods hot (> 60C) or cold (< 4C) in shallow containers and covered, if they are to be stored for more than 2 hrs. Temporarily exclude people with boils, abcesses and other purulent lesions of hands, face or nose from food handling.

OUTBREAK
One outbreak of staph food poisoning occurred at a convention

in Chicago . A banquet meal included ham, potato salad, baked beans, rolls, chocolate cake and assorted drinks. Six hours after the meal, about one-third of the conventioneers developed cases of staph food poisoning. When the foods served were examined, the ham was found to be highly contaminated with staph bacteria. CAUSE: The ham had been baked the day before and refrigerated overnight. The next day, a cook with an infected cut on his

 finger sliced the ham The sliced ham was stacked in

layers,wrapped in aluminum foil, warmed and held for several hours before serving.

ERRORS AND PREVENTIONS: First, the employee with the infected cut should have cleaned and covered it with a bandaid and glove. Second, the contaminated slices should not have been piled in layers but spread so the heat could have penetrated and killed the bacteria. Third, the sliced ham should not have been heated until just before serving, eliminating time for bacterial growth. It should have been held hot, above 140 degrees F, which would have prevented bacterial growth.

REFERENCES
Estes Reynolds, George Schuler, William Hurst & P.T. Tybor, Preventing

food poisoning and food infection, The University of Georgia College of Agricultural & Environmental Sciences Communicable disease management protocol, staphyloccocus food intoxication Text book of Food Borne diseases by Dean.O.Oliver, Academic Press, 1990